HomeMy WebLinkAboutAlternative Service AgreementGeoteehnicat Engineering ..
U. N 1 V I k.-SAL" : construction Material's Testing & -Inspection
EN.GINEf.RING SOMNOES
:. ..
Building Code Compliance
• Occupational Health -& Safety .
Environmental
rounded in Excellence. - Building Envelope.
G.
ALtern-ative ' Service Agreement:
Project: ' DR Horton-Creekside- 3432 Trinity -Circle, fort Pierce, FL 34945=Lot 26
Private Provider Firm: Universal Engineering Sciences
Private Provider Name: John Carl Peterson-..
Address:.607 Commodity. Cove, Port St"Au- cie::FL 34986
Phone: f7721.924-3575 : Fax:47.721"924-3580
Names; License/Certificate Numbers, and License description of provider and:duly authorized agents.who will be
providing services for this project:
Name.
License/Certificate No:::
•License/Certificate.'Type , .
Matthew Chaney
BN#:7342
Inspebtor.Building..
.Don Determan_ .
BN# 4688 :.::
Inspector _:Building..(1'and 2'family),; Plumbing'.
Joseph Duprey.,'
BN#:7330 _
'Inspector.=.Buildin 9: =.
Carl Peterson :' .
BN# 5555 RPX#243:.Inspector.=:MEP,'Building.
:
Michael. Benton '.:
BN#.8067
...
Inspector- Inspector-Building.(1 and 2 family), ' .. .
Mechanical, Plumbing.. . .
Donald: Green
BN#7301' .
'Inspector -Electrical
VincentBurdo :.
BN#5337 :-
..Inspector.Electrical,'Plumbing Mechanical.
As the private inspection services provider for this project, I have. read and agree to be,bound "to the provisions..of State.
Statute 553.791,. I further agree and understand that only the above listed personnel may perform inspections ori.this -
-project and that- if for any -reason the inspection personnel'should change,'or-if any person listed above -should discontinue
to quality as a:daly authorized agent, you'will.be notifie ritin medi
Representative Name:
- - Signature
State of Florida, County_of Palm Beach,
Sworn to.(or affirmed) and subscribed_ before me.this day of , 2021, by C 1�" lJr)
who is. personally known to me.
. JC IBIS
Printed: name of otarv: • lgnature of NotaryAP
Notary Public Stamp:
' Jr'v'•• BRMrANv LV4N JOL11T15.
NoTary Public • State of Ficrida
Commislian 41 10641K
i My Comm, ExGires liar 21. 2025
Bcnaed :nrougr ra ero� %atery assr.